out.

Story checks out.

So this patient has a respiratory acidosis.

Okay, now we're going to interpret the bicarb in the context of the anion gap and strong ion difference.

And in this patient, we look and we get our BMP, and he has a bicarb of 15. and we do the math, and it turns out his anion gap is high.

His anion gap is 23, and his strong ion difference is, let's say, 38.

It's normal.

So, yeah, what are we going to do here, Sarah?

It's entitled It's Complicated, and maybe I'll let her expand on that a little bit.

And so this is kind of where we're getting a little meta and we're trying to help people form a mental model of how you create mental models, basically, and then how you convey them.

And I think the key components of that are first making it accessible.

Because if you're watching an expert do something and it just seems like magic, you're like, oh, that's cool, but I'm never going to be able to do that.

So making it accessible enough, first bringing it to a level that they're like, oh, I can actually envision myself not just watching this and being like, yeah, but being like, I actually can do this.

Then you have to make it comprehensible.

And the problem with this is often if you watch what an expert does, but then you ask them to teach it, they do very different things.

So I think putting a higher priority on teaching, I think would be a, a key component of that in our academic institutions.

So do we just have to depend on people doing medicine that they want to strive to become experts themselves rather than us forcing them into it with some sort of assessment program? How do we get people to want to do this?

So I think that you have to do a couple things.

One, you have to inspire them to want to be better.

You can't tell them to want to be better.

You have to show them something they want to be.

And we've all seen this in sports or music.

I am not a very athletic person.

What are the type of topics that you're aiming to teach in that environment?

First, first procedure, check your own pulse.

Exactly.

[laughs] That is the one which is consistently high in this situation, but having a place to go.

And so I like to think of this in two pretty simple categories.

The first is where the heart itself is the major culprit versus the patients where the heart is at least a semi-innocent bystander.

So the patients where the heart itself is the culprit, these are your patients with some kind of major structural heart disease, whether it's coronary artery disease, ischemic or non-ischemic cardiomyopathy, valvulopathy, something like that.

They have a sick heart for whatever reason.

He, he would have contractions too.